93 Decision Citation: BVA 93-12879
Y93
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 90-18 120 ) DATE
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THE ISSUE
Entitlement to secondary service connection for a left knee
disorder.
REPRESENTATION
Appellant represented by: The American Legion
WITNESS AT HEARINGS ON APPEAL
The veteran
ATTORNEY FOR THE BOARD
Richard V. Chamberlain, Counsel
INTRODUCTION
The veteran had active service from June 1974 to August 1985.
In November 1986, the Department of Veterans Affairs (VA)
Regional Office (RO) in Nashville, Tennessee, denied
secondary service connection for a left knee disorder (on
the basis that it was not shown to exist) and notified the
veteran later that month. The veteran did not submit a
timely appeal. Since the final unappealed decision the
veteran has submitted additional evidence in support of an
application to reopen the claim for secondary service
connection for a left knee disorder, at least some of which
satisfies the definition of new and material evidence (e.g.,
medical evidence showing the current existence of a left
knee disorder). 38 U.S.C.A. § 5108 (West 1991); 38 C.F.R.
§ 3.156(a) (1992); Colvin v. Derwinski, 1 Vet.App. 171
(1991). Since there is new and material evidence, the claim
is considered reopened and has been considered on a de novo
basis. See 38 U.S.C.A. § 5108; Manio v. Derwinski, 1
Vet.App. 140 (1991).
In 1989 the veteran submitted an application to reopen a
claim for secondary service connection for a left knee
disorder. A rating decision in November 1989 denied the
claim. The veteran submitted a notice of disagreement in
January 1990, and a statement of the case was issued later
that month. In January 1990, the veteran submitted a
substantive appeal. The veteran testified at a personal
hearing at the RO in February 1990. The case was received
and docketed at the Board of Veterans' Appeals (Board) in
April and May 1990, respectively. The veteran is
represented by The American Legion, and that service
organization submitted written argument to the Board in
August 1990.
The Board remanded the case to the RO in November 1990.
Supplemental statements of the case were issued in February,
May and October 1991. The veteran testified at a personal
hearing at the RO in December 1991. A supplemental
statement of the case was issued in July 1992. The veteran
testified at another personal hearing at the RO in August
1992. A supplemental statement of the case was issued in
September 1992. The case was returned to the Board in
February 1993. In April 1993, the veteran's representative
submitted another written argument to the Board.
In the written argument of April 1993, the representative
indicates that the veteran wants to appeal recent rating
decisions which denied secondary service connection for a
left hip disorder and an increased evaluation for his
service-connected right knee disability. These matters have
not been certified to the Board and will not be addressed by
us. They are referred to the RO for action as may be
appropriate.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran maintains that symptoms of his service-connected
right knee disorder caused him to place more weight on his
left knee which resulted in a chronic left knee disorder.
He requests secondary service connection for the left knee
disorder.
DECISION OF THE BOARD
In accordance with the provisions of 38 U.S.C.A.§ 7104,
following review and consideration of all evidence and
material of record in the veteran's claims file, and for the
following reasons and bases, it is the decision of the Board
that the preponderance of the evidence is against the claim
for secondary service connection for a left knee disorder.
FINDING OF FACT
A chronic left knee disorder is not causally related to the
veteran's service-connected right knee disability.
CONCLUSION OF LAW
A chronic left knee disorder is not proximately due to or
the result of a service-connected disability. 38 C.F.R.
§ 3.310(a).
REASONS AND BASES FOR FINDING AND CONCLUSION
The record shows that the veteran's claim is well grounded,
meaning that it is not inherently implausible. 38 U.S.C.A.
§ 5107(a). The VA has a duty to assist a veteran in
developing facts pertinent to a well-grounded claim. Id.
We find that the RO has obtained all relevant evidence for
an equitable disposition of a claim and that there is no
further VA duty to assist the veteran.
A. Factual Background
Service medical records show that the veteran was seen for
pain in both knees in March 1975 and was assigned to
quarters for three days. In July 1984 he complained of left
knee pain after a 10 mile road march. It was noted he had a
history of problems with the right knee but not the left
one. Clinical evaluation of the left knee showed no
abnormality. Service records show that the veteran was seen
on various occasions for a right knee disorder, and during a
period of hospitalization in 1985 he underwent right knee
arthroscopy and arthroscopic excision of medial plica. The
diagnoses were large right knee medial synovial plica with
corresponding Grade I chondromalacia of the medial femoral
condyle and patella.
When discharged from service in August 1985, the veteran
filed a VA compensation claim, asserting that he had a right
knee disability from service; he made no reference to left
knee problems. A rating decision in 1985 granted service
connection for torn medial meniscus of the right knee and
assigned a 10 percent rating from August 1985, and granted
service connection for postoperative residuals of an excision
of an osteoma of the right frontal bone (forehead) and
assigned a noncompensable rating from August 1985. A rating
decision in 1989 increased the evaluation for the right knee
disorder from 10 percent to 20 percent from February 1989.
Service connection has not been granted for any other
disorder.
The veteran first claimed secondary service connection for a
left knee disorder in July 1986. He underwent VA examination
in August 1986. He complained of pain in his right and left
knees. He stated that his left knee pain was the result of
undue support to compensate for his right knee pains. His
left knee was not examined at that time.
The veteran testified at a personal hearing in February 1987
in regard to a claim for an increased evaluation for his
right knee disorder. He stated that pain in his right knee
caused him to place more stress on his left knee.
The veteran underwent right knee joint arthroscopy with
subtotal medial meniscectomy during a period of VA
hospitalization in March 1987. Examination of the left knee
joint revealed no abnormalities.
VA outpatient treatment records in 1989 show that he was
primarily seen for his right knee disability, but
occasionally had left knee complaints. In August 1989, the
impression was possible patellar tendinitis of the left
knee. A left knee arthrogram in November 1989 showed a
horizontal tear of the medial meniscus and a Baker's cyst.
The veteran again claimed secondary service connection for a
left knee disorder in November 1989. He testified at a
personal hearing at the RO in February 1990. He stated that
his VA examination in 1986 was inadequate to determine the
nature of any left knee disorder and that due to his
service-connected right knee disorder he had to place more
stress on his left knee which resulted in a left knee
disorder. He said he felt he had the left knee problem
since service, although he received no treatment for it
until 1989.
VA outpatient treatment records in 1990 and 1991 show
continued left knee complaints.
The veteran underwent VA examination in August 1991 to
determine the nature and extent of any left knee disorder
and any relationship to his service-connected right knee
disability. At the time of the examination, he had
bilateral knee braces. The diagnoses were postoperative
arthroscopy of the right knee times 2; early degenerative
arthritis of the medial compartment of the right knee; and
patellar tendinitis, bilaterally. The examiner concluded
that the only abnormality of the left knee was basically
patellar tendinitis. The examiner opined that there was
most likely no significant relationship between the patellar
tendinitis of the left knee and the problem associated with
his right knee.
The veteran testified at a personal hearing in December 1991
to the effect that his right knee caused him to put more
pressure and weight bearing on his left knee which resulted
in a left knee disorder.
The veteran underwent right knee surgery for a torn medial
meniscus during a period of VA hospitalization in January
1992.
The veteran testified at a personal hearing at the RO in
August 1992. He stated that he first had problems with his
left knee around 1985, which became worse in 1986. He
stated that no doctor had related his left knee disorder to
his service-connected right knee disorder. He stated that
he walked with a limp because of his right knee disorder
which caused him to put more stress on his left knee, and
resulted in a left knee disorder. He stated that he
occasionally used a cane for ambulation and occasionally
fell down because of his right knee disability.
B. Legal Analysis
Service connection may be granted for disability which is
proximately due to or the result of a service-connected
disease or injury. 38 C.F.R. § 3.310(a).
The service and post-service evidence does not demonstrate
the presence of a chronic left knee disorder until around
1989. There have been various diagnostic impressions,
including patellar tendinitis, a Baker's cyst, and a
horizontal tear of the medial meniscus. While the VA
examination in 1986 did not examine the left knee, it was
examined during a period of VA hospitalization in 1987 and
no abnormalities were found. Statements of the veteran and
his testimony at personal hearings are to the effect that he
has a chronic left knee disorder which is due to his having
to place more weight or stress on his left knee because of
his service-connected right knee disability. The veteran,
being a layman, has no competence to give a medical opinion
on causation. Espiritu v. Derwinski, 2 Vet.App. 492 (1992);
see also Grottveit v. Brown, No. 93-20 (U.S. Vet. App. May 5,
1993). His statements and testimony are of slight probative
value in the absence of medical evidence to support them.
The medical evidence of record does not relate a left knee
disability to the veteran's service-connected right knee
disorder and the veteran's testimony indicates that no
physician has told him of such a relationship. Also, the
report of his VA examination in 1991 suggests that there is
no relationship between these disorders.
After consideration of all the evidence, we find that the
preponderance of it is against the claim for secondary
service connection for a left knee disorder.
ORDER
Secondary service connection for a left knee disorder is
denied.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
*
(MEMBER TEMPORARILY ABSENT) STEPHEN A. JONES
L. W. TOBIN
*38 U.S.C.A. § 7102(a)(2)(A) (West 1991) permits a Board of
Veterans' Appeals Section, upon direction of the Chairman of
the Board, to proceed with the transaction of business
without awaiting assignment of an additional Member to the
Section when the Section is composed of fewer than three
Members due to absence of a Member, vacancy on the Board or
inability of the Member assigned to the Section to serve on
the panel. The Chairman has directed that the Section
proceed with the transaction of business, including the
issuance of decisions, without awaiting the assignment of a
third Member.
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991), a decision of the Board of Veterans' Appeals granting
less than the complete benefit, or benefits, sought on
appeal is appealable to the United States Court of Veterans
Appeals within 120 days from the date of mailing of notice
of the decision, provided that a Notice of Disagreement
concerning an issue which was before the Board was filed
with the agency of original jurisdiction on or after
November 18, 1988. Veterans' Judicial Review Act, Pub. L.
No. 100-687, § 402 (1988). The date which appears on the
face of this decision constitutes the date of mailing and
the copy of this decision which you have received is your
notice of the action taken on your appeal by the Board of
Veterans' Appeals.